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In the absence of rapid and adequate treatment, exposure to a high dose of cyanide can result in death within minutes due to the inhibition of cytochrome oxidase resulting in arrest of cellular respiration

Changes in vitamin B12 prescribing alone could make between 600 and 1470 hours available for other patient needs

While such reactions are uncommon, they require immediate medical attention

A consultation with a Primary Care Provider is still a good idea if: Your B12 levels are persistently low or high without explanation You have a family history of autoimmune conditions or GI cancers You are vegan, over age 60, or on long-term medications that may interfere with B12 If symptoms persist, especially if they worsen, seeking medical attention is important to determine the cause and start appropriate treatment, says ter Keurs

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